• 제목/요약/키워드: mortality function

검색결과 379건 처리시간 0.025초

성선호에 따른 유아의 성별 차별사망력: 중국의 조선족, 한족과 다이족의 비교분석 (Sex Preference and Sex Differentials in Child Mortality: A Comparative Analysis of Koreans, Hans and Dais in China)

  • 김두섭
    • 한국인구학
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    • 제23권2호
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    • pp.143-166
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    • 2000
  • 이 연구는 상이한 성선호의 문화적 전통을 지닌 인종집단들을 대상으로 하여 의료수준과 유아사망력의 관계를 파악하기 위한 것이다 이를 위해 1990년 중국인구센서스 중에서 연변자치 주에 거주하는 조선족과 한족 그리고 서쌍판납자치주의 한족과 다이족의 원자료를 활용하였다. 이 논문은 성선호, 사회경제적 수준, 의료수준과 유아의 성별 차별사망력의 관계를 설명하기 위한 새로운 모형을 제시하고 있다. 의료인력이 널리 가용한 지역사회에서는 유아사망력의 수준이 성선호에 의하여 영향받을 가능성이 낮다. 그러나 지역사회의 의료수준이 낮으면, 특정한 성을 선호하는 경향이 강한 인종집단의 구성원들은 선호하는 성의 자녀들의 생존을 위하여 모든 노력을 기울이게 될 것이다. 이에 반해서 부모들이 선호하지 않는 성의 자녀생존을 위한 행위들은 이에 수 반되는 비용이나 여러 가지 조건들에 의하여 영향을 받게될 것이다. 따라서 선호하는 성의 유아사망력의 수준은 선호하지 않는 성의 그것에 비해 월등히 낮을 가능성이 크다. 그러나 사회경제적 발전과정에서 의료수준이 향상되고 이에 수반되는 비용이 낮아지면, 선호하지 않는 성의 유아사망력은 급격히 감소하고 성별 사망력의 차이는 줄어드는 경향을 보이게 된다. 이 연구에서 강한 남아선호관을 지닌 조선족 및 한족과, 반대로 여아를 선호하는 경향이 강한 다이족의 유아사망력을 분석한 결과는 이러한 명제들을 뒷받침 해준다.

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좌심실기능에 따른 관상동맥우회술의 위험인자 (Risk Factors of Coronary Artery Bypass Grafting According to Ventricular Function)

  • 이헌재;현성렬
    • Journal of Chest Surgery
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    • 제30권9호
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    • pp.885-890
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    • 1997
  • .저자들은 1994년 7월부터 1996년 6월까지 관상동맥우회 술을 시행한 환자 103명을 심실구축력 40%를 기준 으로 심실기능저하군 24명과 심실기능정상군 79명으로 분류하여 환자의 술전,수술변수 18개를 분석하였다. 분석결과 환자의 특성과 수술사망에 영향을 미치는 위험인자에 대해 다음과 같은 결과를 얻었다. 1. 술전 변수중 심비대(p=0.0012), 혈청 크레아티닌 이상(p=0.0166), IABP 실시(p=0.0096)는 기능저하군이 기능 정상군보다 유의하게 높은 빈도를 보였다 2. 수술변수중 기능저하군은 수술적응증에 있어서 심근경색후 협심증의 빈도가 많았고(p=0.00003), 내흉동맥 의 사용은 유의하게 적었다(p=0.00416). 3. 조기사망률은 기능저하군이 기능정상군보다 약간 높았으나 통계적으로 유의한 차이는 없었다(기능저하군 8.3%, 기능정상군 5.1%, p=0.5492). 4. 합병증발생률은 기능저하군 50%(12/24), 기능정상군 33%(79/25)로 두군간에 유의한 차이는 없었다(p=0.1007). 5. 심실기능정상군에서는 연령(고령)(p=0.041)이 수술후 조기사망에 유의한 위험인자로, 심실기능저하군에서 는 연령(p=0.018)외에도 술전 IAaP 실시(p=0.0036), 고콜레스테롤혈증(p=0.00 7), 응급수술(p=0.0036)이 유의 한 위험인자로 작용하였다. 이상의 결과를 통해 심실기능이 저하된 관상동맥질환 환자는 심실기능이 정상인 환자에 비해 많은 술후 조기사망의 위험인자를 갖고있으나.술후 조기사망률과 합병증 발생률은 두 군간에 유의한 차이를 보이지 않 음으로써 심실기능이 저하된 환자에 있어서도 증상의 개선과 장기생존률의 향상을 얻기 위하여 좀더 적극적인 관상동맥우회 술의 실시가 필요할 것으로 생각된다.

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전폐절제술의 임상적 연구 (Clinical Evaluation of Pneumonectomy)

  • 박진규;김민호;조중구;김공수
    • Journal of Chest Surgery
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    • 제29권9호
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    • pp.996-1002
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    • 1996
  • 전북대학교병원 흉부외과학 교실에서는 1979년 8월부터 1995년 8월까지 73례의 전폐절제술을 시행하였으며, 그 중 폐암이 53례, 폐결핵이 10례, 기관지 확장증이 4례, 기타가 6례 이었다. 73례에서 수술사 망율 및 합볏증을 조사하고 술후 6개월에 53명의 환자에서 폐기능 검사를 시행하여 이에 영향을미치는 인자(나이:성별, 병리소견(양성 또는 악성), 동반질환, 술전 폐기능 검사, 수술시간 등)를 통계학적으로 비교 분석하였다. 수술 사망율에 대해서는 술전 최대자발호기량(MW)의 예측치에 대한 백분율(P=0.013)과 수술시간 (P=0.009)이, 술후 합병증에 대해서는 염증성 질환(P=0.015)이, 그리고 술후 6개월후에 시행한 폐기능 검사치에 대해서는 술전 노력성 폐활량의 예측치에 대한 백분율(FVC(%. prod), p=0.0018),술전 1초간 강제 호기량의 예측치에 대한 백분율(FEVI 3%, prod), p=0.0024),술전 최대 자발성 호기량의 예측치에 대한 백분율(MW 3%. prod), p=0.0043) 등이 통계학적으로 의의 있게 나타났다. 결론적으로수술후의 사망율과 합병증을 줄이고 환자의 원활한 활동능력을 얻기 위해 술전의 환자의 전신상태,심혈관계 및 술전의 폐기능과술후의 保맨\ulcorner폐기능에 대한충분한 평가가 있어야 하며, 염증성 질환이 있는 환자는 염증및 분비물의 성상및 정도를 정확하게 평가하여야 할 것으로 사료된다.

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Acute Pulmonary Thromboembolism: 14 Years of Surgical Experience

  • Park, Jiye;Lim, Sang-Hyun;Hong, You Sun;Park, Soojin;Lee, Cheol Joo;Lee, Seung Ook
    • Journal of Chest Surgery
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    • 제52권2호
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    • pp.78-84
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    • 2019
  • Background: Pulmonary thromboembolism (PTE) is a life-threatening disease with high mortality. This study aimed to assess the outcomes of surgical embolectomy and to clarify the sustained long-term effects of surgery by comparing preoperative, postoperative, and long-term follow-up echocardiography outcomes. Of 22 survivors, 21 were followed up for a mean (median) period of $6.8{\pm}5.4years$ (4.2 years). Methods: We retrospectively reviewed 27 surgical embolectomy cases for massive or submassive acute PTE from 2003 to 2016. Immediate and long-term follow-up outcomes of surgical embolectomy were assessed on the basis of 30-day mortality, long-term mortality, postoperative complications, right ventricular systolic pressure, and tricuspid regurgitation grade. Results: The 30-day and long-term mortality rates were 14.8% (4 of 27) and 4.3% (1 of 23), respectively. Three patients had major postoperative complications, including hypoxic brain damage, acute kidney injury, and endobronchial b leeding, respectively (3.7% each). Right ventricular systolic pressure (median [range], mm Hg) decreased from 62.0 (45.5-78.5) to 31.0 (25.7-37.0, p<0.001). The tricuspid valve regurgitation grade (median [range]) decreased from 1.5 (0.63-2.00) to 0.50 (0.50-1.00, p<0.05). The improvement lasted until the last echocardiographic follow-up. Conclusion: Surgical embolectomy revealed favorable mortality and morbidity rates in patients with acute massive or submassive PTE, with sustained long-term improvements in cardiac function.

Outcomes of Sleeve Lobectomy versus Pneumonectomy for Lung Cancer

  • Lee, Hong-Kyu;Lee, Hee-Sung;Kim, Kun-Il;Shin, Ho-Seung;Lee, Jae-Woong;Kim, Hyoung-Soo;Cho, Sung-Woo
    • Journal of Chest Surgery
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    • 제44권6호
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    • pp.413-417
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    • 2011
  • Background: Sleeve lobectomy for lung cancer in close proximity to or involving the carina is widely accepted. Operative morbidity and mortality rates, recurrence, and survival rates have varied considerably across studies. Materials and Methods: From March of 2005 to July of 2010, sleeve lobectomy was performed in 19 patients and pneumonectomy was performed in 20 patients. In this paper, the results of sleeve lobectomy and pneumonectomy for patients with lung cancer will be compared and evaluated. Results: There were no postoperative complications in either group, but there was one mortality in the pneumonectomy group. There was better preservation of pulmonary function in the sleeve lobectomy group than the pneumonectomy group (p=0.066 in FVC, p=0.019 in FEV1). The 3-year survival rates were 46.7% in the sleeve lobectomy group and 54.5% in the pneumonectomy group (p=0.505). The 3-year disease-free survival rates were 38% in the sleeve lobectomy group and 45.8% in the pneumonectomy group (p=0.200). Conclusion: Sleeve lobectomy for lung cancer showed low mortality, low bronchial anastomotic complication rates, and good preservation of pulmonary function.

Prognostic Factors and Clinical Outcomes of Acute Intracerebral Hemorrhage in Patients with Chronic Kidney Disease

  • Kim, Jin Kyu;Shin, Jun Jae;Park, Sang Keun;Hwang, Yong Soon;Kim, Tae Hong;Shin, Hyung Shik
    • Journal of Korean Neurosurgical Society
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    • 제54권4호
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    • pp.296-301
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    • 2013
  • Objective : We conducted a retrospective study examining the outcomes of intracerebral hemorrhage (ICH) in patients with chronic kidney disease (CKD) to identify parameters associated with prognosis. Methods : From January 2001 to June 2008, we treated 32 ICH patients (21 men, 11 women; mean age, 62 years) with CKD. We surveyed patients age, sex, underlying disease, neurological status using Glasgow Coma Scale (GCS), ICH volume, hematoma location, accompanying intraventricular hemorrhage, anti-platelet agents, initial and 3rd day systolic blood pressure (SBP), clinical outcome using the modified Rankin Scale (mRS) and complications. The severity of renal functions was categorized using a modified glomerular filtration rate (mGFR). Multifactorial effects were identified by regression analysis. Results : The mean GCS score on admission was $9.4{\pm}4.4$ and the mean mRS was $4.3{\pm}1.8$. The overall clinical outcomes showed a significant relationship on initial neurological status, hematoma volume, and mGFR. Also, the outcomes of patients with a severe renal dysfunction were significantly different from those with mild/moderate renal dysfunction (p<0.05). Particularly, initial hematoma volume and sBP on the 3rd day after ICH onset were related with mortality (p<0.05). However, the other factors showed no correlation with clinical outcome. Conclusion : Neurological outcome was based on initial neurological status, renal function and the volume of the hematoma. In addition, hematoma volume and uncontrolled blood pressure were significantly related to mortality. Hence, the severity of renal function, initial neurological status, hematoma volume, and uncontrolled blood pressure emerged as significant prognostic factors in ICH patients with CKD.

Outcomes of Open Surgical Repair of Descending Thoracic Aortic Disease

  • Lee, Won-Young;Yoo, Jae Suk;Kim, Joon Bum;Jung, Sung-Ho;Choo, Suk Jung;Chung, Cheol Hyun;Lee, Jae Won
    • Journal of Chest Surgery
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    • 제47권3호
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    • pp.255-261
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    • 2014
  • Background: To determine the predictors of clinical outcomes following surgical descending thoracic aortic (DTA) repair. Methods: We identified 103 patients (23 females; mean age, $64.1{\pm}12.3$ years) who underwent DTA replacement from 1999 to 2011 using either deep hypothermic circulatory arrest (44%) or partial cardiopulmonary bypass (CPB, 56%). Results: The early mortality rate was 4.9% (n=5). Early major complications occurred in 21 patients (20.3%), which included newly required hemodialysis (9.7%), low cardiac output syndrome (6.8%), pneumonia (7.8%), stroke (6.8%), and multi-organ failure (3.9%). None experienced paraplegia. During a median follow-up of 56.3 months (inter-quartile range, 23.1 to 85.1 months), there were 17 late deaths and one aortic reoperation. Overall survival at 5 and 10 years was $80.9%{\pm}4.3%$ and $71.7%{\pm}5.9%$, respectively. Reoperation-free survival at 5 and 10 years was $77.3%{\pm}4.8%$ and $70.2%{\pm}5.8%$. Multivariable analysis revealed that age (hazard ratio [HR], 1.10; 95% confidence interval [CI], 1.05 to 1.15; p<0.001) and left ventricle (LV) function (HR, 0.88; 95% CI, 0.82 to 0.96; p<0.003) were significant and independent predictors of long-term mortality. CPB strategy, however, was not significantly related to mortality (p=0.49). Conclusion: Surgical DTA repair was practicable in terms of acceptable perioperative mortality/morbidity as well as favorable long-term survival. Age and LV function were risk factors for long-term mortality, irrespective of the CPB strategy.

Spatial Point-pattern Analysis of a Population of Lodgepole Pine

  • Chhin, Sophan;Huang, Shongming
    • Journal of Forest and Environmental Science
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    • 제34권6호
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    • pp.419-428
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    • 2018
  • Spatial point-patterns analyses were conducted to provide insight into the ecological process behind competition and mortality in two lodgepole pine (Pinus contorta Dougl. ex Loud. var. latifolia Engelm.) stands, one in the Lower Foothills, and the other in the Upper Foothills natural subregions in the boreal forest of Alberta, Canada. Spatial statistical tests were applied to live and dead trees and included Clark-Evans nearest neighbor statistic (R), nearest neighbor distribution function (G(r)), and a variant of Ripley's K function (L(r)). In both lodgepole pine plots, the results indicated that there was significant regularity in the spatial point-pattern of the surviving trees which indicates that competition has been a key driver of mortality and forest dynamics in these plots. Dead trees generally showed a clumping pattern in higher density patches. There were also significant bivariate relationships between live and dead trees, but the relationships differed by natural subregion. In the Lower Foothills plot there was significant attraction between live and dead tees which suggests mainly one-sided competition for light. In contrast, in the Upper Foothills plot, there was significant repulsion between live and dead trees which suggests two-sided competition for soil nutrients and soil moisture.

Long-Term Outcome of Chronic Obstructive Pulmonary Disease: A Review

  • Jo, Yong Suk
    • Tuberculosis and Respiratory Diseases
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    • 제85권4호
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    • pp.289-301
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    • 2022
  • Chronic obstructive pulmonary disease (COPD) is a chronic airway inflammation characterized by fixed airflow limitation and chronic respiratory symptoms, such as cough, sputum, and dyspnea. COPD is a progressive disease characterized by a decline in lung function. During the natural course of the disease, acute deterioration of symptoms leading to hospital visits can occur and influence further disease progression and subsequent exacerbation. Moreover, COPD is not only restricted to pulmonary manifestations but can present with other systemic diseases as comorbidities or systemic manifestations, including lung cancer, cardiovascular disease, pulmonary hypertension, sarcopenia, and metabolic abnormalities. These pulmonary and extrapulmonary conditions lead to the aggravation of dyspnea, physical inactivity, decreased exercise capacity, functional decline, reduced quality of life, and increased mortality. In addition, pneumonia, which is attributed to both COPD itself and an adverse effect of treatment (especially the use of inhaled and/or systemic steroids), can occur and lead to further deterioration in the prognosis of COPD. This review summarizes the long-term outcomes of patients with COPD. In addition, recent studies on the prediction of adverse outcomes are summarized in the last part of the review.

Growth Data of Broiler Chickens Fitted to Gompertz Function

  • Duan-yai, S.;Young, B.A.;Lisle, A.;Coutts, J.A.;Gaughan, J.B.
    • Asian-Australasian Journal of Animal Sciences
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    • 제12권8호
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    • pp.1177-1180
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    • 1999
  • This study describes the growth of broiler chickens to the two forms of Gompertz function for application in broiler production models. The first form is based on the estimated mature weight ($W_A$), while the second is based on the estimated hatch weight ($W_O$). Both equations gave identical estimation because they are mathematically identical. To fit the growth curve of commercial broilers that marketed at 35-42 days, it is unnecessary to keep broilers to near maturity (> day 140) to obtain growth data for deriving the Gompertz function. This date does not improve the curve fitting of the early growing period. Additionally, a high mortality and health problem occurred to this type of chicken after day 105.